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General NPI Number Information
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NPI Number | 1952351751
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Entity Type | Individual
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Provider Name | JUSTIN MICHAEL JONES MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 6305 WATERFORD BLVD SUITE 115
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-1122
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Country | US
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Telephone | 405-848-3459
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Fax | 405-848-5401
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Provider Business Mailing Address
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Address Line | 6709 REED DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-2130
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Country | US
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Telephone | 405-848-7767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 22456
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License Number State | OK
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